Provider Demographics
NPI:1497356133
Name:SALEEM, DEONTA MARCELL
Entity Type:Individual
Prefix:
First Name:DEONTA
Middle Name:MARCELL
Last Name:SALEEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 FORT DAVIS ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-1044
Mailing Address - Country:US
Mailing Address - Phone:703-655-9510
Mailing Address - Fax:
Practice Address - Street 1:2400 HARTFORD ST SE APT 104
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7967
Practice Address - Country:US
Practice Address - Phone:202-290-6989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant